益生菌预防肝硬化自发性腹膜炎的疗效

Effect of microbial phytase on spontaneous peritonitis of patients with hepatic cirrhosis

目的探讨预防肝硬化腹水并自发性膜腹炎的方法与效果。方法选择肝硬化腹水并自发性腹膜炎患者共43例,随机分为益生菌组15例,抗生素组15例,对照组13例。三组患者住院后均给予抗感染、护肝、利尿、对症支持等常规治疗10~14 d。此后,益生菌组给予双歧三联活菌胶囊0.63 g/d,6个月;抗生素组给予诺氟沙星胶囊200 mg,口服,每日1次;对照组未做特殊处理。三组均于用药内6个月进行定期复查,评价其有效率、自发性腹膜炎再发率及小肠细菌过生长情况。结果 （1）疗效：6个月内益生菌组总有效率为86.7%,再生率为13.3%,抗生素组有效率为93.3%,再发率为6.7%;对照组自发性腹膜炎再发率为46.2%。益生菌组与抗生素组的总有效率、再生率比较,差异无统计学意义（P〉0.05）,但两者与对照组相比,差异均有统计学意义（P〈0.05）。（2）小肠细菌过生长情况：治疗前后对照组阳性率无变化,益生菌组及抗生素组阳性率显著下降（P〈0.05）,益生菌组与抗生素组与对照组相比,差异有统计学意义（P〈0.05）,益生菌组下降率与抗生素组比较,差异无统计学意义（P〉0.05）。结论益生菌及抗生素在预防和治疗自发性腹膜炎方面均有良好疗效,不良反应少、复发率低,值得临床推广。

Objective To discuss the preventive measures of spontaneous peritonitis in patients with hepatic cirrhosis.Methods 43 patients with spontaneous peritonitis of hepatic cirrhosis were randomly divided into three groups：microbial phytase group,antibiotic group and control group.All patients were treated with anti-infectious treatment,liver treatment,diureses for 10~14 d.Then microbial phytase group was given Bifid-triple viable capsule（0.63 g,3 times a day）for 6 months,antibiotic group was given norfloxacin capsule（200 mg,once a day）for 6 months,control group was not given any treatment.The curative effect and small intestinal bacterial overgrowth were observed.Results ①Curative effect：statistical differences were found between patients of microbial phytase group and control group（P〈0.05）,antibiotic group and control groug（P〈0.05）,there was no significant difference between antibiotic group and microbial phytase group（P〈0.05）.②Small intestinal bacterial overgrowth：the rates were descent in microbial phytase group and antibiotic group,statistical differences were found between microbial phytase or antibiotic group and control group（P〈0.05）.Conclusion Microbial phytase and antibiotic are effective for preventing spontaneous peritonitis in patients with hepatic cirrhosis.